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Understanding the Complexities of Recruitment and Retention of Allied Health Professionals in Rural Health Settings

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Thesis(6.9 MB)

Date

2023

Authors

George, Jane

Supervisor

Kayes, Nicola
Larmer, Peter

Item type

Thesis

Degree name

Doctor of Health Science

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Publisher

Auckland University of Technology

Abstract

The health workforce is stretched to its limits in Aotearoa and abroad. Rural and remote communities, which are often the first to be impacted by workforce shortages, are struggling to recruit and retain staff. Targeted investment in academic, political, and financial strategies have aimed to increase the numbers of doctors and nurses entering the workforce, and to support them to stay. Comparatively little has been done for the professions that make up the umbrella group, Allied Health Scientific and Technical. This doctoral research explored ways to support recruitment and retention in rural communities in these workforces by answering the following questions: What do Allied Health Professionals (AHPs) identify as the attractive aspects of living and working rurally? How could this inform how we recruit and retain AHPs in rural and remote settings? Reviews of the literature explored what was known about these workforce groups and how they chose rural practice. The reviews also sought to understand the strategies utilised by other health professions and to what effect. The literature review was followed by an Interpretive Descriptive study, using qualitative interviews to explore the perspectives and experiences of 18 allied health participants with rural and remote health experience. Utilising Reflexive Thematic Analysis, the interview transcripts were analysed for meaning in relation to the research questions. The research identified four significant concepts which are critical to the experiences of AHPs. The first theme is Sense of Connection and Belonging which captures the ways that AHPs feel connected to their rural work and community setting. The second theme is Safe and Supported Practice and focuses on those components which enable AHPs to do their best work. The third theme is Creating Roles People Want to Come For which looks at the various elements that make roles attractive. These were interwoven with a fourth concept of Fit, a sense of being in the right space, place, and time. In addition to identifying these themes, a collection of practical recommendations has been distinguished for those entities most able to change practice in ways that will enhance the experiences of rural AHPs and, in turn, increase the efficacy of recruitment and retention in rural and/or remote health settings. These entities are people leaders, organisations, recruiters, tertiary education providers, registering bodies and professional associations. The findings and recommendations, which detail meaningful opportunities to enhance the relationships and resources of AHPs in rural and/or remote health settings, offer a significant contribution to knowledge. The research challenges the existing structures in health systems which privilege medicine and nursing, from resource allocation to scopes of practice, as the system that affects decision-making and empowerment. It has implications for those in leadership, recruitment, education, profession advocacy and governance. It shows that, given the chance, we can build an effective and stable AHP workforce to serve rural and remote communities throughout Aotearoa for years to come.

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http://hdl.handle.net/10292/16965

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Doctoral Theses